Medical changes from 1945

There were many medical changes during World War Two
but these changes continued after the war. In Britain, the biggest change was
the establishment of the National Health
Service (NHS) that provided free medical care for all regardless of wealth.
Prior to this those who could not afford something like a penicillin jab had to
go without or make the necessary sacrifices to get the necessary money. The NHS
provided this for free.

Post-1945, many advances were made in the management of
pregnancy and childbirth. This included the ability to induce labour and the use
of epidurals to ease difficult pregnancies. As a balance to this, there was a
move for less state intervention in childbirth and the development of the right
for women to have more natural childbirth. In 1956, the National Childbirth
Trust was set up. The chance of infant survival also improved as medical
knowledge developed – as was seen in the work done to increase the survival
rate of ‘blue’ babies. The greater use of scans after 1945 also helped to
detect problems earlier.

More vaccines were developed to control childhood
diseases. After the war the health of children was generally better than at any
other time in history. Vaccines against polio, measles and rubella were
developed in the 1950’s and 1960’s. Tests were also developed for defects in
babies such as the amniocentesis for spina bifida and Down’s Syndrome.
Treatments were also developed for children with heart disease.

After 1945, major advances were also made in birth
control. In earlier times there had been advances in rubber sheaths but they
were seen more as a protection against syphilis as opposed to a form of birth
control. The cap or diaphragm had been developed in the 1880’s but its
availability had been very much limited as people were kept in the dark as to
its very existence. Marie Stopes did much to change attitudes as to give women
more freedom when concerning birth control. However, pre-war social conventions
had done much to prevent the total spread of her ideas throughout Britain. Many
social conventions had been swept away during the war and by the 1950’s the
contraceptive pill had been introduced as was seen as a way of giving women more
control over their own destiny – and certainly taking this away from
domineering men. By the 1960’s, the contraceptive pill was widely available,
as was the IUD (Intrauterine device). This had first been developed in 1909 but
was more widely available after 1945. Certain types of IUD were also linked to
pelvic infection and septic abortions as late as the 1970’s and 1980’s. Such
concerns did much to stymie its use.

Many very significant medical advances were also made
after 1945. One of the most important was the discovery of DNA by Wilkins, Crick
and Watson. These three were also helped by the work done by Rosalind Franklin.
DNA is the substance that makes life – a human cell that contains genes, which
are made up of chromosomes, the basis of living tissue. This has in turn allowed
the study of disease caused by defective genes such as in cystic fibrosis and
Down’s Syndrome. In recent years, researchers have been able to identify
specific genes that are responsible for specific diseases.

New drugs have also been created post-1945. The success of
penicillin during the war, prodded researchers to study other moulds.
Streptomycin, found in chickens, was used successfully to treat TB. This
treatment was pioneered primarily in America after 1946. Streptomycin was also
found to be capable of treating many other diseases that penicillin could not.
However, it was found that too much use of streptomycin could lead to the TB
germ developing a resistance to its use. After 1951, streptomycin was used with
Isoniazid in the fight against TB. This again was developed in America. By the
1970’s, five antibiotics existed which could be used against TB. In recent
years, despite this array of drugs against TB, there have been fears that TB can
be resistant to all drugs that have been developed to fight it. The recent rise
of TB in the more depressed areas of Britain’s cities has concerned many
doctors. The problems with streptomycin did lead scientists to study why drugs
lost their effectiveness and also why some people suffered side effects when
they were used and others did not. The development in pharmacology has been a
major development since 1945.

Since 1945, there has been a greater use of steroids in
medicine. These were used to relieve pain and inflammation. Cortisone was used
in injection form to treat rheumatoid arthritis. Cortisone also had the
important side effect of reducing the body’s immune system. This made it
useful to prevent the rejection of skin and kidney transplants. This in turn
lead to the idea of using drugs to suppress the growth of cancers using
cytotoxins.

The use of ultrasound and magnetic resonance since 1945
has also made it easier to diagnose disease. Ian Donald, Professor of Midwifery
at Glasgow developed ultrasound in the 1950’s for looking at unborn babies.
Magnetic Resonance Imaging can be used to detect diseases without the use of
radiation making it less harmful to the patient. Three-dimensional CAT scans can
also be used. The less use of radiation the better as some patients can be
harmed by exposure to large doses of radiation. MRI (Magnetic Resonance Imaging)
does away with this problem. The use of modern equipment such as the endoscope
has also allowed for the internal examination of patients without the need for
surgery.

Kidney dialysis was first tried in 1914 but only became
more widely available in the 1960’s. The introduction of long term and
repeated dialysis gave hope to patients who almost certainly would have died
without this particular development.

Surgery in general has witnessed major developments since
1945. Far more operations can be carried out now on areas of the body that were
rarely touched before 1945. Christian Barnard’s heart transplant was on an
organ that few surgeons would have operated on. His pioneering surgery inspired
others to do likewise and now heart operations are very common, as is surgery on
organs such as the liver and kidneys etc. Microsurgery and keyhole surgery are
common place now – as is the use of lasers in surgery. The major – though
not exclusive – developments in surgery are as follows:

Post 1953: the development of a successful heart lung
machine allowed more complicated heart surgery to take place. Techniques have
improved greatly here with coronary bypasses to improve blood supply to the
heart since 1953 and the replacement of heart valves since the 1960’s.
Artificial arteries have also been developed to improve blood flow. After 1961,
pacemakers were introduced to maintain a regular heart beat.

From 1960 on, lasers were used to treat eye tumours etc.

Transplant surgery has also developed aided by drugs like
cortisone, azathioprine and cyclosporin which have helped to reduce rejection.
The first successful kidney transplant was done in Boston in 1954; the first
heart transplant was in 1967 (performed by Christian Barnard); the first liver
transplant was in 1963; the first heart and lung transplant was in 1982 and the
first brain tissue transplant was in 1987.

Since 1945, there have been major developments in
replacement surgery. Hip replacement was pioneered by John Charnley, orthopaedic
surgeon at Manchester Royal Infirmary. Since then, there have been knees and
elbows have been replaced.

In the area of reproduction, the development of IVF by
Patrick Steptoe, led to the first test tube baby – Louise Brown – born in
1978. Steptoe’s work has given much hope to those couples who want children
but have had difficulties producing them. However, the issue of IVF brought with
it many ethical issues which cause controversy to this day.

Since 1945, there have been massive strides in the
treatment of cancer. The use of a combination of drugs, radiotherapy and surgery
have greatly increased a cancer patient’s chances of survival. During the 1950’s,
research linked smoking to lung cancer and other external factors have also been
identified – such as excess sunlight potentially causing skin cancer. It is
now thought that 15% of all cancers are caused by viruses.

The major disease that has tested the medical world since
the 1980’s has been HIV/AIDS. In the 1980’s, government’s touted HIV as
near enough a death sentence and in Britain issued public health warnings on
television showing icebergs crashing into the sea. Now, just twenty years on,
combination drug therapy offers sufferers hope and a huge amount of research has
gone into finding a cure or vaccination for this world-wide disease. ‘New’
diseases have also come to the fore including the Ebola virus.

There is a vast difference in the medical world of 1945 to
that of 2002. Developments within medicine would have been expected but they
have been in leaps in the last decades. Diseases that would have almost
certainly killed in 1945 to 1950 are now usually treatable and in many instances
curable.